Provider Demographics
NPI:1588982060
Name:ASSURED IMAGING WOMENS WELLNESS OF WASHINGTON, LLC
Entity type:Organization
Organization Name:ASSURED IMAGING WOMENS WELLNESS OF WASHINGTON, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-774-8828
Mailing Address - Street 1:7717 N HARTMAN LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-9506
Mailing Address - Country:US
Mailing Address - Phone:206-467-1949
Mailing Address - Fax:206-467-1912
Practice Address - Street 1:565 ANDOVER PARK W STE 110
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-3357
Practice Address - Country:US
Practice Address - Phone:206-467-1949
Practice Address - Fax:206-467-1912
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSURED IMAGING WOMEN'S WELLNESS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-10
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile MammographyGroup - Single Specialty